ENPC Questions And Answers With The Latest Updates
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Components in the prioritization of pediatric emergency care (4) correct answer: pat, focused assessment (objective
information), focused pediatric hx(subjective information), assignment of an acuity rating decision
Pediatric assessment triangle : (3) components correct answer: appearance. Work of breathing. Circulation to the skin.
This forms the "general impression".
If there is an acute disruption in 1 component, child is "sicker".
If there is an acute disruption in 2+ components the child is "sickest"
Pediatric assessment triangle : appearance correct answer: most important. Reflects adequacy of ventilation,
oxygenation, brain perfusion, and central nervous system function.
Assess for : tone, instructiveness, censurability, look/gaze, and speech/cry.
Pediatric assessment triangle : work of breathing correct answer: breathing easy, even, and unlabored or tripod
position, nasal flaring, retractions, supraclavicular retractions
Pediatric assessment triangle : circulation to the skin correct answer: mottling or pwd
Pqrst for pain correct answer: (pg86)
Precipitating and palliating factors
Quality
Radiation
Severity, symptoms, and site
Time or triggering factors
Verbal report for pain correct answer: (pg86)
Self-report is the most reliable indicatior of pain; however not all pediatric pt are capable or wiling to verbalize their
discomfort.
What age is the respiratory system considered fully developed? Correct answer: 8 years old
Most ______ age __to____, are concrete thinkers and interpret words literally.
Where as, most _____ age ___ to ___, are magical and illogical thinkers. They often confuse coincidence with causation,
and have difficulty distinguising fantasy from reality. Correct answer: (pg36)
Most toddlers age 1yo to 3yo , are concrete thinkers and interpret words literally.
Where as, most preschoolers age 3yo to 5yo, are magical and illogical thinkers. They often confuse coincidence with
causation, and have difficulty distinguising fantasy from reality.
Hypotension related to hypovolemia in pediatric trauma patients is a _____ sign and may indicate a loss of ___% to
___% of their circulating blood volume. Correct answer: (pg262)
Late sign.
20% to 25% of circulating blood volume
6p's assessment for musculoskeletal trauma correct answer: (pg 283)
Pallor : color different from uninjured
Pain
Pulselessness
, Parasthesia
Paralysis
Poikilothermia
Burn transfer criteria correct answer: 1. Partial thickness >10% of bsa
2. Face, hands, feet, genetalia, perineum or major joints
3. Third degree burns in any age group.
4. Electrical burns, including lightning injury, and chemical burns.
5. Inhalation injury.
6. Burn injury in pt with preexisting medical disorders that could complicate tx.
7. Concomitant trauma (such as fx) in which the burn injury poses the greatest risk of morbidity or mortality.
8. Burned children in hospital wo qualified equipment or personnel to care for them
9. Pt who will require special social, emotional, or rehabilitative intervention.
If live interpreter not available for 15mins use ________ correct answer: language line interpreter
Infants are obligate nose breathers. If nose is obstructed ___________ correct answer: suction nose
Opiod antidote correct answer: narcan
Benzo antidote correct answer: romazicon
Neutropenic pt with a temperature correct answer: don't take rectal temp.
No invasive procedures if not necessary.
Nonblanchable rashes of concern correct answer: meningocoxcemia
Petiachia/purpura
Bicycle accident concerns correct answer: did pt strike handle bars?
Possible abdominal injury
Ribs are more horizontal and provide less protection.
Normal urine output for child correct answer: 1 to 2ml / kg / hr
Differences of child vs adult : bsa, blood volume, glycogen storage, metabolic rate correct answer: children have :
increased bsa(predispose to temp dysregulation), decreased circulation blood volume(predispose to hypovolemia),
decreased glycogen storage(predisoposed to hypoglycemia), increased metabolic rate.
Oral rehydration for 9month old with mild dehydration. Correct answer: glucose and sodium solution, every 2 to 5min
with 5 to 10ml
6week old infant, no medical hx. Eating poorly, vomiting, "hard to wake up", responsive to pain. Anterior fontanel
bulging, tachypnic. Diagnostic evaluation expected? Correct answer: skeletal survey
Possible shaken baby syndrome
Minimal acceptable bp's correct answer: newborn = 60
Infant = 70
Child = 70 + (2 x age in yrs)
All critically ill patients require _____ level correct answer: glucose due to low glycogen stores